Insight, analysis & opinion from Joe Paduda
An article in Physicians News yesterday suggested providers look to workers comp to make up revenue losses from Medicare and commercial payers’ declining reimbursement. That wasn’t stated explicitly, but you don’t have to be a code-breaker to get author Franklin … Continue reading Cost shifting to work comp – sure, go ahead!
Read More...Current Florida Insurance Commissioner and NAIC Chair Kevin McCarty led off his talk with a description of drug repackaging as a “license to steal.”. I absolutely agree. He expressed optimism when noting the legislative effort will continue next year; on … Continue reading NCCI’s second day – state v fed regulation
Read More...We’re drinking from the firehose that is Bob Hartwig’s annual discussion of economic factors affecting the property and casualty industry. His presentation was – as usual – high energy and entertaining. Example – noting that a Greek default would have … Continue reading Hartwig’s take; the economy and P&C insurance
Read More...When it comes to health reform, perhaps the only thing Congressional Republicans agree on is they hate ObamaCare. There’s no agreement on a basic framework much less consensus on an actual bill. Moreover, there are parts of ObamaCare that enjoy … Continue reading GOP alternatives to Obamacare
Read More...Last week’s post on the recent release of Annual Reports by PBMs Progressive, PMSI, and Express Scripts, got me thinking (spurred by a friend’s query); if PBMs produce these reports as a matter of course, why don’t other specialty medical … Continue reading Pharmacy Benefit Managers – if they report, why doesn’t everyone?
Read More...Tis the season for drug trend reports. Recent releases from PMSI, Express Scripts (ESI), and Progressive Medical show an ever-increasing level of sophistication and growing insight into cost drivers in workers comp pharmacy. Moreover, the layout, graphics, use of charts … Continue reading Work comp drug trends reports – tis the season
Read More...With the appointment of Danielle Lisenby as CEO, Broadspire’s board affirmed the TPA’s focus on medical management, and served notice that the company will compete based on that focus. Lisenby’s replacement as Broadspire SVP medical management is Erica Fichter, who … Continue reading Broadspire’s new CEO
Read More...As insurers abandon the traditional “usual and customary” metric in favor of Medicare’s rates for out of network reimbursement, consumers are getting hit with higher bills, and many are protesting. That’s understandable; it’s also necessary. The usual and customary reimbursement … Continue reading The necessary demise of Usual & Customary
Read More...Quick takes Weather If exhibitor presence is an indicator of where the world is headed, the insurance world is very concerned about catastrophes. Several of those huge cat cleanup vehicles were on the exhibit floor at this year’s RIMS conference, … Continue reading RIMS, day two
Read More...The single biggest crisis facing workers comp is NOT the market cycle, employment, rate adequacy, or regulatory changes. It is opioids. As Gary Franklin MD, Washington state fund’s Medical Director says, this is a “hair on fire” issue. I’m not … Continue reading Is your hair on fire yet?
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